High cholesterol... fact vs fiction?

[tankgirl73]

So my hubby has just been told he has high cholesterol...  His HDL levels were good, but his LDL levels were high... 5.3 where the upper limit is 5.2, though I don't know the units (he had a very rushed visit with the nurse who scrawled some numbers on a post-it note, we don't have the full bloodwork results).

They gave him a photocopied sheet of all the "heart-healthy" foods, a kind of "so you have high cholesterol" guideline sheet.  And of course, it's all no-fat this, lean that, no butter, no lard, etc etc.

Over the past several years I've been moving us in the direction of TF diet... We don't drink a lot of milk, but what we use is organic full-fat.  I use real butter and render my own lard, I save bacon grease and use it in all kinds of things.  I've read some of the stuff about saturated fat being the scapegoat based on faulty research that's never been properly challenged.  It just makes sense to me that our bodies are designed to need and use animal fats.

I got some vindication when I had blood tests done myself last year -- my cholesterol levels, high and low, were perfect.  Textbook.  And I have some other issues going on, genetic high blood pressure (not affected by diet/exercise/etc) for instance, low iron and B12 (will be evaluating for pernicious anemia after the current course of treatment).  But cholesterol?  No problem.  Low-fat suggestions be away with you, TF works.

Now we get hubby's results and they're the opposite of mine. Good grief, between the two of us I'm the one with the worse diet (I have the greater tendency to overeat and to splurge on junk food).  He gets lots of exercise... he runs, he's swims, he jogs, he curls... I'm a lump on the couch (though I'm trying to improve heh).  His blood pressure is even on the LOW end of normal, his resting heart rate is 60 or LESS.  

So this just doesn't make sense to me... 

And even assuming it's accurate... what do we do about it now?  Switching to the ultra-low-fat diet just feels so wrong to me now.  I mean, anything that low-fat is extra processed, or has junk added to it to replace the taste that comes from the fat.  It doesn't make sense that a high-processed diet is "healthier."  But if I insist that we keep doing what we're doing, I don't know if he'd go along with it.  He was already anxious about his cholesterol, that's why he asked for the bloodwork even though he's healthy, it's just something that's been gnawing at him for years (we didn't have a family dr until last year).  He's only 38.  If he thinks I'm not concerned about his health that I'm not willing to change our diet for his sake... well I know *I* wouldn't appreciate that if roles were reversed.

And I really don't like the idea of having to keep 2 kinds of food in the house... My daughter is only 4, she needs full-fat everything whatever food philosophy you subscribe to (and she's a beanpole).  My 12yo son is on medication that reduces his appetite, and he's a stick to begin with, we need to pack as much punch into what he eats as we can.  So if DH goes no-fat, he would need separate food.  And I'd have to cook separate meals... all the bacon fat, lard, etc... sigh. I'm trying to SIMPLIFY, not add complexity...

And I don't even know that it's necessary, despite what the medical establishment says.  I've read some stuff (but don't fully understand or remember it) about how cholesterol tests are meaningless, or unrelated, that it doesn't directly measure cholesterol anyway, or there's corelation but no causation, or I don't know what.  But if we SHOULD be changing things for hubby's sake, I don't want to not do so just because I'm stubborn and don't want to believe the mainstream doctor, you know?

So... what's the deal with cholesterol?

[onetrumpeter]

subbing as we have similar test results...  my mom just started a statin drug...  not sure exactly what to think!

[ambereva]

I think you're doing a little bit of either/or fallacious thinking here. Kale is low fat and it's neither processed nor tasteless. Not that I'm advocating low fat. But just because something is low fat doesn't mean it's processed or unhealthy.

All I know is that when I started getting most of my calories and nutrition from whole plant foods, my health began improving, my LDL dropped to the low 50's and my HDL started climbing (from low 40's to low 60's over the last two years). It seems that for me, improved health correlates with low LDL and higher HDL (I am not ascribing a causation here). Every body is different, of course. What works for me won't necessarily work for you, or your husband. I just want to encourage you to allow yourself to think outside the box you've built in which low fat = processed and high fat = healthy. There's a lot more to it than that! Maybe experiment with more plant based meals that you all enjoy, and supplement your and your childrens' diets with the lard and dairy. Science does overwhelmingly show a correlation between animal fat and high cholesterol, again, not ascribing causation, just acknowledging that the bulk of research does show a correlation. And in your dh's case, maybe it's worth noting.

OH, PS, I get tons of saturated fats from plant sources (nuts, chocolate, coconut oil, etc), and it has obviously not raised my LDL, so I'm with you in not buying that saturated fat is necessarily the culprit behind high cholesterol.

Originally Posted by tankgirl73 Switching to the ultra-low-fat diet just feels so wrong to me now.  I mean, anything that low-fat is extra processed, or has junk added to it to replace the taste that comes from the fat.  It doesn't make sense that a high-processed diet is "healthier."  But if I insist that we keep doing what we're doing, I don't know if he'd go along with it.

[tankgirl73]

Oh I know that plants are low-fat and non-processed.  :)  I do understand that.  When I talk about "low-fat = processed" I mean in terms of things that are REDUCED fat, not things that are naturally low-fat in the first place.  Sorry if I wasn't clear on that!  I'm just trying to reconcile my current dietary beliefs (saturated animal fats = healthy, necessary, and incorrectly blamed for heart disease) with the dietary advice my husband is now getting... and with his blood test results of course. 

We do eat lots of veggies, we get a CSA box through the summer and I have a small backyard garden.  Our meat is primarily grass-fed beef, which is typically leaner than regular beef and has more of the good fats, omega 3's etc.

I'm not advocating eating a HIGH fat diet across the board -- just that we're not SCARED of fats, and I'll use natural full-fat products over their reduced-fat counterparts, *when we use fat* or fatty products.

But virtually everything we routinely eat -- other than the veggies -- is on the "avoid" list DH got.  I'm not convinced yet that he does need to avoid them... that's what I'm trying to figure out.  I mean, it even has coconut oil on the 'avoid' list.

Science does overwhelmingly show a correlation between animal fat and high cholesterol

Does it?  That's what I need to figure out.  I thought I'd read that it's a false connection from one poorly done study decades ago... but I've been wrong before and could be again.  ;)  What are some sources?  All the stuff I read now just states it as though it's common sense fact that everybody knows and doesn't need backing up -- I need to see the actual data.  :)

And I'm still struggling with the whole concept because my own levels were so textbook perfect, and he eats better, exercises better, etc etc than I do!  It's hard for him to have a healthier diet than he does -- the only change really is to go "low fat"... all the other "do this to get better" suggestions don't apply to him -- his blood pressure is low, he exercises and is fit, has never smoked, doesn't drink, etc etc...  With all the other risk factors being non-existent for him, is this something he really needs to be so anxious about?

[ambereva]

Originally Posted by tankgirl73 

Does it?  That's what I need to figure out.  I thought I'd read that it's a false connection from one poorly done study decades ago... but I've been wrong before and could be again.  ;)  What are some sources? 

And I'm still struggling with the whole concept because my own levels were so textbook perfect, and he eats better, exercises better, etc etc than I do!  It's hard for him to have a healthier diet than he does -- the only change really is to go "low fat"... all the other "do this to get better" suggestions don't apply to him -- his blood pressure is low, he exercises and is fit, has never smoked, doesn't drink, etc etc...  With all the other risk factors being non-existent for him, is this something he really needs to be so anxious about?

Yes. Scientific data suggests a correlation. It might be a false connection, because 'conventional wisdom' tends to assign causation where there is only correlation. Whether there is causation is still very much up in the air and more study is needed. But yes, scientific data suggests a correlation, it wasn't just one poorly done study, it is a vast body of data, most of which supports the correlation.
 

I get my information from actual scientific articles, not from books or 'news' articles. When I run across an article or idea that peaks my interest, I dig around until I find the study/studies that the idea or article is based on. So I can't point you toward a specific resource. Many times I find that authors have clearly injected their own agenda into their interpretations of scientific data.

I don't know if he needs to be anxious, I think this is something you guys will have to decide on your own, based on the information you have. I don't see any reason not to experiment with his diet and see what happens though.

[Auntie Sapphire]

And I'm still struggling with the whole concept because my own levels were so textbook perfect, and he eats better, exercises better, etc etc than I do!  It's hard for him to have a healthier diet than he does -- the only change really is to go "low fat"... all the other "do this to get better" suggestions don't apply to him -- his blood pressure is low, he exercises and is fit, has never smoked, doesn't drink, etc etc...  With all the other risk factors being non-existent for him, is this something he really needs to be so anxious about?

Well, remember that his genetic history is different from yours - possibly, very different - so he may have risk factors that are not under his control. However ...

His HDL levels were good, but his LDL levels were high... 5.3 where the upper limit is 5.2, though I don't know the units (he had a very rushed visit with the nurse who scrawled some numbers on a post-it note, we don't have the full bloodwork results).

The units are millimoles (mmol) per liter (L) of blood. According to this Mayo Clinic web page, 5.3 is the lowest possible value for "borderline high" cholesterol. They define "high" cholesterol as above 6.2 mmol/L. I would definitely ask for a printout of the full bloodwork results. 

[Marnica]

After much research on my own, I do not think high cholesterol is associated with heart disease, or that high fat = high cholesterol. In fact I have come to see how valuable a role cholesterol plays. Cholesterol is needed by the boy to repair and protect tisue.

This article nicely sums up what have discovered:

http://www.westonaprice.org/know-your-fats/538-cholesterol-and-heart-disease-a-phony-issue.html

this also may provide you with some info

http://www.heart-disease-bypass-surgery.com/data/articles/36.htm

In the alternative health circles - cholesterol is not a bad thing!

to above poster - Ive been trying to get my dad off statin drugs for a while. They are BAD BAD BAD!!!

All statin drugs block your body's production of cq10. This nutient is critical to cellular energy

http://www.statindrugdangers.com/

[sophiesgrandma]

My HDL was great (77) but my LDL was too high at 135. I was already exercising and eating lots of veggies. I decided to cut out the sugar and white flour and rice (which I was only eating a little of). I do admit I was eating too much sugar. I added 2 tablespoons of ground flax to my diet and upped my nuts and olive oil and ate even more veggies and fruits. My protein comes from beans, wild salmon and sardines with some chicken and very rarely beef.

I eat tons of broccoli, cauliflour, carrots, kale, spinach, onions, garlic and lots of blueberries when available. I eat as much organic as possible.

I eat some cheese but not daily. Lots of plain greek yoghurt. Some skim milk.

I also upped my exercise from 1 hour to 1 1/2 hours  6 times a week. Within 6 weeks my LDL went down to 126 which is within normal range. I have to think the change in my diet and increase in exercise helped as my LDL was too high for a couple of years until I cut out most white sugar, etc.

I do occasionally have bacon or other saturated fat type meats but not much-maybe 2-3 times a year. No butter except what I may get in my food in a restaurant.

My biggest advice would be increase exercise and lots of veggies and fruits-that should be the majority of the diet.

My dh had to have stents and start a statin a few years ago due to chest pain on exertion and almost closed heart arteries. He too had very low/normal blood pressure but high LDL. He's doing much better now.

[tankgirl73]

Thanks for all the comments.

We had a chat about it the other day and DH had some interesting thoughts.  First, he wasn't as oppositional about my lines of thinking as I had thought he might be.  He *is* worried about his cholesterol, but he shares some of my dietary skepticism.  He does not want the family to alter our diet, using bacon grease and full-fat rather than processed/skimmed dairy, etc etc.  He said something about how he's okay with going off milk (rather than making us buy 2 different types), what he's really going to miss is his nuts and seeds.  They're on the handout they gave him in the "limit" category.  BUT -- there's an asterisk with 'nuts and seeds', and when you look at the footnote it says "This food contains healthy fats but is high in calories."

Um, hello!!!  He doesn't need to lose weight!  He doesn't have to worry about calories!  If anything, if he's getting his necessary calories from foods with healthy fats isn't that a GOOD thing because it 'fills him up' so he doesn't eat stuff with 'bad fats'?????

Probably the list is designed with the assumption that most folks with high cholesterol are overweight and need to lose weight.  But that's a TERRIBLE assumption to make.  Have 2 separate lists if that's an issue... one list with 'everything' for the overweight folks and one with ONLY the high-saturated-fat items for those who have high levels but are otherwise healthy.

He'd had some niggling doubts about the list, but when I showed him that footnote, he actually got angry.  Misinformation from the dr is NOT helpful!

And he's as baffled as I am about how come his levels are high, but mine are low, when he eats better and gets more exercise than me.  During the warmer months, he jogs/runs pretty much every night for an hour -- he's hoping to work up to even doing some marathons eventually.  He's recently started swimming -- does laps at the local pool for 1/2 hour to and hour before work twice a week and again on the weekends.  And he curls twice a week in the winter months.  He's 180lbs but that's at a full 6'5".  And 1/2", actually.  ;)

The brilliant observation that he made though... is that he doesn't have a baseline, a previous cholesterol check to compare this with.  It's only been the past few years that we've started eating better, and only this past year that he's starting exercising as intensely.  He lived pretty poorly before that, especially before we got together 9 years ago.  He figures it's just as likely that his levels were HIGHER, and they're now IN THE PROCESS OF DROPPING.  We just happened to catch them when they're almost down to normal... but not having a previous test that was higher, the assumption is that they're high and he needs to change in order to get them to drop.

So his plan is to reduce fats by reducing dairy, and eliminating his junk food (mainly chips, doritos) -- which was already severely reduced from how much he USED to eat but he's sure he can cut it out pretty much completely.  And make sure he maintains his exercise.  Otherwise, keep things pretty much as they are diet-wise.  Then retest in a few months or so, and see if there's a downward trend.  If it's still just as high or increasing, then we'll know there's something else going on and he needs to make a more drastic change.  But there's no point in stressing about it until we know what direction his numbers are actually heading!

Question for those who have reduced their numbers -- how long did you wait between tests?  How long does it take for diet changes to show results in the numbers?

[neverdoingitagain]

When you get your FULL results back, check out this link and do the equations involved. Having an LDL level just slightly above norm, I'm sure you agree, is not as dire as your doctor seems to think. That would be like giving a statin for having a total cholesterol of 201 when the limit is 200. 

 I totally agree with your dh's theory that his numbers might actually be dropping. It would be a good idea to have his cholesterol checked in another 6 months. Then you would have a better basis for comparison. Until then, its not worth worrying about.

Good luck Heather! 

[brightblonde]

I just wanted to chime in here. I'm a general internist and I tend to follow the NCEP/ATP 3 guidelines; if you Google this you'll be able to see the full recommendations yourself which may be helpful. We measure cholesterol with different units but it appears that your husband falls into the borderline high category. If he were my patient, I would want to know about his other cardiac risk factors (blood pressure, family history, smoking, etc) as well as his own past medical history. Cholesterol goals are a moving target based on each patient's other cardiac risk factors; so if I have a patient with isolated high cholesterol, normal blood pressure, non-smoker, and otherwise healthy, I would likely not recommend any treatment for cholesterol other than to emphasize the importance of healthy life-style (exercise, good diet, etc).

I'll also add that there are definitely people out there who have high cholesterol despite extremely healthy life-style. These people often have a family history of coronary artery disease, and their cholesterol and overall cardiac risk is probably driven more by genetics than diet and exercise. Statin medications are often vilified but I find the evidence that they reduce the risk of cardiac events and stroke to be very convincing.

I think having his cholesterol rechecked is a perfectly reasonable idea, but you want to make sure you allow enough time to really see any change (3 months at least, 6 months is probably better). Hope that is helpful to you!

[beanma]

Cutting down on carbs can really help reduce cholesterol. I think cutting out the Doritos and other junk food will really help him. Other junky carbs or carb-intense foods except oatmeal (which helps reduce cholesterol) can be eliminated or reduced too to help bring it down.